关键词: 视网膜动脉硬化, 臂踝脉搏波传导速度, 颈股脉搏波传导速度

Abstract: Objective To investigate the association of brachial-ankle pulse-wave velocity (baPWV) and carotid-femoral pulse-wave velocity (cfPWV) with retinal arteriosclerosis in a community-based population in Beijing. Design Cross-sectional study. Participants A total of 751 subjects with complete questionnaire, baPWV, cfPWV and fundus photograph data were included from an atherosclerosis cohort of Peking University First Hospital in Shijingshan District, Beijing, followed up from December 2019 to January 2020. Methods Retinal arteriosclerosis was graded according to Scheie’s classification by an experienced ophthalmologist. Logistic-regression model were used to investigate the association of PWV indices and retinal arteriosclerosis grading. Main Outcome Measures baPWV, cfPWV, retinal arteriosclerosis grading. Results Subjects were 62.3±7.3 years old, 61.0% (n=458) were female, 54.9% (n=412) had hypertension, 78.3% (n=588) had dyslipidemia, 32.8% (n=246) had diabetes, and 11.6% (n=87) had cardiovascular disease. baPWV and cfPWV was 17.1±4.0 m/s and 9.1±2.2 m/s respectively. In Logistic-regression model analysis, there was a positive correlation between baPWV and retinal arteriosclerosis grading after adjustment for sex, age, BMI, smoking status, fasting plasma glucose, systolic blood pressure(SBP), total cholesterol, triglycerides, eGFR group, hypoglycemic agents, lipid-lowering drugs, antihypertensive drugs, dyslipidemia and history of cardiovascular disease. Retinal arteriosclerosis increased 6% for every 1 m/s increase of baPWV (OR=1.06, 95%CI: 1.00-1.12, P=0.037). Compared with baPWV<14 m/s group, the risk of retinal arteriosclerosis aggravation increased 74% in subjects with baPWV≥14 m/s (OR=1.74, 95%CI: 1.12-2.70, P=0.013). Compared with baPWV<14 m/s group, the risk of retinal arteriosclerosis aggravation increased 66% in subjects with baPWV between 14 m/s and 18 m/s (OR=1.66, 95%CI: 1.07-2.59, P=0.025). Compared with baPWV<14 m/s group, the risk of retinal arteriosclerosis aggravation increased 125% in subjects with baPWV≥18 m/s (OR=2.25, 95%CI: 1.29-3.91, P=0.004). However, no significant relationship was observed between cfPWV and retinal arteriosclerosis grading. Conclusions baPWV was significantly associated with Scheie’s retinal arteriosclerosis grading. The higher the baPWV, the more severe the retinal arteriosclerosis. Compared with cfPWV, baPWV can better reflect the degree of retinal arteriosclerosis. (Ophthalmol CHN, 2021, 30: 337-342)

Key words: retinal arteriosclerosis, brachial-ankle pulse-wave velocity, carotid-femoral pulse-wave velocity